Thyroid Cancer / Nodules & Hyperthyroidism Expert Forum
Thyroglobulin level going back up
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Thyroglobulin level going back up

I am a 31 year old female. In October of 2009, my thyroid was removed due to papillary thyroid cancer.  Lymph nodes were removed at the time as well, and the cancer was found to have spread to one of them.  I was treated with RAI, scan after RAI came back saying that nothing was absorbed outside the neck.  11/2010 my thyroglobulin levels were up to 39.6. I had an MRI done and a spot was seen on it, so I had a second surgery 12/10.  Following this surgery, my thyroglobulin levels dropped to 1.6 within about 6 weeks.  6/11 my thyroglobulin levels started to raise again, and were at 2.1, in August 2012, I had another dose of RAI, after which, my level dropped down again to 1.3.  I recently had blood work done again, and my thyroglobulin levels have started to raise again. This time is was 2.5. Does this indicate reoccurance or that there is still some thyroid tissue growing somewhere?  I have an appointment scheduled with my endocrinologist, but its not for a month and I dont want to make myself crazy over nothing if it really is nothing.  


Lab results
2/11- TSH 1.61, Free T4 1.6, Thyroglobulin 1.6, Thyroglobulin Antibodies <20(Levothyroxine increased to 150 mcg)
6/11- TSH .27, Free T4 1.6, Thyroglobulin 2.1, Thyroglobulin Antibodies <20
10/11-TSH .3, Free T4 1.2, Thyroglobulin 1.3, Thyroglobulin Antibodies <20
11/12- TSH .68, Free T4 .77, Thyroglobulin 2.5, Thyroglobulin Antibodies <20
97953_tn?1193367871
The detectable thyroglobulin level needs to be watched for an upward trend over time.  Your last I-131 was only 3 months ago, so it is quite possible that if this was effective the Tg level will drop.
Ultrasound of the neck would be indicated as part of routine follow-up in this case as well as CT of the chest (esp if the Tg trends upward and ultrasound is normal).  Would not recommend additional I-131 without a second opinion.
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Mark Lupo, M.D.Blank
Thyroid & Endocrine Center of Florida
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